In Message for World Toilet Day, Secretary-General Urges that Sanitation Be at Heart of Post-2015 Development Framework

Following is UN Secretary-General Ban Ki-moon’s message for World Toilet Day, observed on 19 November:

Each year, more than 800,000 children under five die needlessly from diarrhoea — more than one child a minute. Countless others fall seriously ill, with many suffering long-term health and developmental consequences. Poor sanitation and hygiene are the primary cause. Worldwide, some 2.5 billion people lack the benefits of adequate sanitation. More than 1 billion people practise open defecation. We must break the taboos and make sanitation for all a global development priority.

This first official observance by the United Nations of World Toilet Day is an opportunity to highlight this important topic. Sanitation is central to human and environmental health. It is essential for sustainable development, dignity and opportunity. Poor water and sanitation cost developing countries around $260 billion a year — 1.5 per cent of their gross domestic product (GDP). On the other hand, every dollar invested can bring a five-fold return by keeping people healthy and productive. When schools offer decent toilets, 11 per cent more girls attend. When women have access to a private latrine, they are less vulnerable to assault.

Despite the compelling moral and economic case for action on sanitation, progress has been too little and too slow. That is why I launched a Call to Action on Sanitation this year to end open defecation by 2025 and build on existing efforts, such as Sanitation and Water for All and the Sanitation Drive to 2015, the target date for achieving the Millennium Development Goals (MDGs).

We are a long way from achieving the MDG target of reducing by half the proportion of people lacking adequate sanitation. We must urgently step up our efforts, with all actors working together for rapid, tangible results. And, as we look beyond 2015, it is essential that sanitation is placed at the heart of the post-2015 development framework. The solutions need not be expensive or technology driven. There are many successful models that can be replicated and scaled up. We must also work to educate at-risk communities and change cultural perceptions and long-standing practices that have no place in our modern world.

By working together — and by having an open and frank discussion on the importance of toilets and sanitation — we can improve the health and well-being of one third of the human family. That is the goal of World Toilet Day.

What is World Toilet Day ?

World Toilet Day is observed annually on 19 November. This international day of action aims to break the taboo around toilets and draw attention to the global sanitation challenge.

Can you imagine not having a toilet? Can you imagine not having privacy when you need to relieve yourself? Although unthinkable for those living in wealthy parts of the world, this is a harsh reality for many – in fact, one in three people on this globe, does not have access to a toilet! Have you ever thought about the true meaning of dignity?

World Toilet Day was created to pose exactly these kind of questions and to raise global awareness of the daily struggle for proper sanitation that a staggering 2.5 billion people face. World Toilet Day brings together different groups, such as media, the private sector, development organisations and civil society in a global movement to advocate for safe toilets. Since its inception in 2001, World Toilet Day has become an important platform to demand action from governments and to reach out to wider audiences by showing that toilets can be fun and sexy as well as vital to life. more…

Abstract

Background

Access to improved sanitation plays an important role in child health through its impact on diarrheal mortality and malnutrition. Inequities in sanitation coverage translate into health inequities across socio-economic groups. This paper presents the differential impact on child mortality and diarrheal incidence of expanding sanitation coverage across wealth quintiles in Nepal.

Methods

We modeled three scale up coverage scenarios at the national level and at each of the 5 wealth quintiles for improved sanitation in Nepal in the Lives Saved Tool (LiST): equal for all quintiles, realistically pro-poor and ambitiously pro-poor.

Results

The results show that equal improvement in sanitation coverage can save a total of 226 lives (10.7% of expected diarrhea deaths), while a realistically pro-poor program can save 451 child lives (20.5%) and the ambitiously pro-poor program can save 542 lives (24.6%).

Conclusions

Pro-poor policies for expanding sanitation coverage have the ability to reduce population level health inequalities which can translate into reduced child diarrheal mortality. more….

Abstract

Introduction Diarrhoeal diseases are leading causes of mortality and morbidity in developing countries. Inspite of many programmes and facilities provided by the government towards prevention of diarrhoeal diseases, it continues to be a threat.
Objective: To study the sanitation and hygiene practices followed by patients of diarrhoea admitted at Infectious Disease Hospital (IDH).

Methodology: A descriptive cross sectional hospital based study conducted on 300 patients admitted at Infectious Diseases Hospital, King George’s Medical University, Lucknow. Patients were interviewed using a predesigned schedule after taking informed consent. Information regarding general characteristics including source of drinking water, sanitation practices, toilet facility available and mode of refuse disposable were taken. Data was analysed using SPSS 17.0 statistical software. Results: Majority (50.67%) of patients’ uses Municipal water supply/tap water as main source of drinking water and 30% patients uses India mark II hand pump. Around two-third of diarrhoeal patient practices hand washing with soap and water after household activities. Majority (63.33%) do not practices safe methods of storing drinking water, 87.33% uses sanitary latrines while 12.6% still uses open field for defecation. Almost half of the patients uses dustbin for refuse disposal. Use of sanitary latrines and India mark II drinking water was positively associated with higher socioeconomic status. Conclusion: In spite of the improved facilities of water and sanitation provided by the government, there exists a lacuna between its availability and their proper utilisation. This leads on to the burden of diarrhoeal patients on the health sector. Proper awareness regarding safe drinking water and sanitation practices and proper refuse disposal can reduce the diarrhoeal load.view pdf…

WASHLink from time to time likes to briefly note newly publish papers in hopes of giving them a wider audience – let us know if you know of paper that could use this very small piece of publicity…

new paper: by Maureen Seguin and Miguel Niño-Zarazúa

“What do we know about non-clinical interventions for preventable and treatable childhood diseases in developing countries?”

Abstract:

Preventable and treatable childhood diseases, notably acute respiratory infections and diarrhoeal diseases are the first and second leading causes of death and morbidity among young children in developing countries. The fact that a large proportion of child deaths are caused by these diseases is symptomatic of dysfunctional policy strategies and health systems in the developing world. Though clinical interventions against such diseases have been thoroughly studied, non-clinical interventions have received much less attention. This paper contributes to the existing literature on child wellbeing in two important respects: first, it presents a theory of change-based typology that emerges from a systematic review conducted on non-clinical interventions against preventable and treatable childhood diseases. Second, it pays particular attention to policies that have been tested in a developing country context, and which focus on children as the primary target population. Overall, we find that improved water supply and quality, sanitation and hygiene, as well as the provision of medical equipment that detect symptoms of childhood diseases, along with training and education for medical workers, are effective policy instruments to tackle diarrhoeal diseases and acute respiratory infections in developing countries. more…

34 page pdf

Seguin, Maureen and Niño-Zarazúa, Miguel (2013): What do we know about non-clinical interventions for preventable and treatable childhood diseases in developing countries? Published in: WIDER Working Paper Series , Vol. 2013, No. 087 (13. September 2013)

WASHLink from time to time likes to briefly note newly publish papers in hopes of giving them a wider audience – let us know if you know of paper that could use this very small piece of publicity…

This is one of the best Sanitation/ Global Health stories we have seen lately. Delivered in a very pleasurable consumable format, by a great speaker who make the topic reachable to a board spectrum of professionals and people. It’s antidotal in nature, while being universal in the realities of solving a village’s sanitation issues. Shyama has an honesty that needs to be incorporated into the newly developing transparency practices oft the world’s NGOs . This talk needs to be shown to the NGO’s and their altruistic “minions” before they venture out to help their global brothers and sisters.

The story starts out after audience imagining life with out toilets with Shyama explaining how she as pure novice, walks into a coastal village after a tsunami, and realizes she must bring the villages toilets back.

She learns along the way “…2.4 billion people don’t even have access to a toilet that functions, 1 billion don’t have access to any toilet the just have to defecate anywhere they can …” Thus the “….lack of waste management and toilets is making a killer that we are not talking about enough … diarrhea…. the number one killer in most developing countries…”

She Googles and contacts “experts” to educates herself with the facts to get the job done or so she thinks.

Upon the last new toilet being being initiated with a squat of a villager behind closed doors, Shyama, unlike many of the NGO’s, does not walked away. The core of her captivating story is what happens afterward … The door is opened, the veil of naivety is exposed and lifted. Where/when most project fall into failure, she and her partner begins the long diagnostic/prognostic/improvement cycle.

Shyama reminds us it is a an effort that is ongoing with more to learn and invites us to come back… It will be a crime if we do not see the next installment of this story as it continues to unfold.

Essential and very practical points abound within her story. One that are be showing up in other stories from around the world- and hopepfully becoming a din that must be addressed. With some paraphrasing, here are a few I see tucked in her tail:
1 NGO’s can’t do it alone and succeed; the villagers are needed – with a vastly redefined roll for NGOs.
2 Technical experts/ engineers may not be the social experts – both are needed.
3 Toilets at the onset are not alway seen as valuable/desirable assets. Education is needed before during and after
4 Women and men of the villages do not have the same perspective on sanitation. The project must address both separately as well as together .
5 Villages without ongoing support services will quickly have “…fossils of abandoned stinking toilets allover…”
6 Schools as an institution do not just naturally promote and desire ecosan toilets. They must also be nurtured. (details not addressed in this piece – but would be important to learn more about)
7 Building heathy social stimulus/pressure/ pride must be part of the scope
8 People who want the toilet must be educated on use and care
9 The villagers must be part of the economic model – the social model. Such pieces as manufacturing / construction/ distribution/ sales/ support / education/ promotion/ etc
10 Microfinance is a viable solution – (a work in progress in the story)
11 Toilets can provide a financially valuable natural resource – fertilizer
12 This all makes it a slower road, but it is a viable road, unlike the fast road the many NGO’s are building.
13 100% may be the target but 80% is a not a bad number to start with- and even that require lots of work.

Shyama reminds us it’s a an effort that is ongoing and invites us to come back ,so to speak. It will be a crime if we do not see the next installment of this story as it continues to unfold.

There is a new paper from JOURNAL OF HEALTH DIPLOMACY that is worth of taking the time to read. Just the impact to combating Global Health issues associated with and tangential to WASH efforts is huge, not to mention many other areas of global health. This 21 page paper does a great job of addressing / itemizing the complexities of a problem, that laymen would think could be solved in a fortnight.

Global Health Diplomacy and the Governance of Counterfeit Medicines: A Mapping Exercise of Institutional Approaches

By Tim K. Mackey*

Abstract

Objective.Counterfeit medicines are a global, multi-faceted, and complex public health problem.Global health diplomacy and cooperative efforts relying on governance systems have been limited in effectively addressing proliferation of this dangerous trade. Methods. This review conducts a comprehensive mapping exercise of governance efforts by international organizations to address counterfeit medicines, including analysis of related international treaties and conventions that may be applicable to anti-counterfeit efforts. This work also reviews governance and global health diplomacy proposals from the literature that addresses counterfeit medicines.

Summary of Findings. A number of international organizations have become active inaddressing the global trade of counterfeit medicines. However, governance approaches by international organizations, including the World Health Organization (WHO), the United Nations Office on Drugs and Crime (UNODC), Interpol and the World Customs Organization (WCO), have varied in scope and effectiveness. Treaty instruments with applicability to counterfeit medicines have also not been fully leveraged to combat this issue. Results indicate that a formalized and multi-stakeholder governance mechanism is needed to address the issue. The UNODC is uniquely situated to act as a forum for such a proposal in partnership with other international organizations.

Implications of Findings. Global health diplomacy efforts to combat counterfeit medicines require multi-stakeholder and formalized governance structures that can leverage stakeholder participation and resources.Through cooperative arrangements leveraging the strengths of partners such as UNODC (combating transnational crime), Interpol (lawenforcement purposes), the WCO (customs and border control), and the WHO (for public health science and analysis), the international community can mobilize a coordinated, inclusionary, health diplomacy response to the crisis of global counterfeit medicines.

* Tim Mackey, MAS, is a Senior Research Associate with the Institute of Health Law Studies, California Western School of Law; a Ph.D. Candidate with the Joint Doctoral Program on Global Health, University of California San Diego-San Diego State University; an Investigator with the San Diego Center for Patient Safety, University of California San Diego School of Medicine; a Clinical Instructor (Health Services) with the Department of Anesthesiology, University of California San Diego School of Medicine; and the Coordinator for Global Health Research with the Joint Program on Health Policy, University of California, San Diego-California Western School of Law. He is a recipient of the 2012 Horowitz Foundation for Social Policy Grant for graduate researchers, the 2011-2012 Carl L. Alsberg, MD Fellow, Partnership for Safe Medicines and the Rita L. Atkinson Fellow, and gratefully acknowledges that support. E-mail: tmackey@ucsd.edu

Journal of Health Diplomacy:

The Journal of Health Diplomacy (JHD) is an open-access, peer-review journal that publishes editorials, original research papers and commentaries on issues pertaining to the field of health diplomacy. In keeping with its objective – of generating and disseminating research to ensure foreign policy decisions and discourses on global health are informed by the best available evidence – issues are published twice annually on a thematic basis; themes are selected based on their timeliness and relevance to the field. JHD welcomes contributions from all academic disciplines, including anthropology, geography, history, international relations, legal studies, political science and sociology.